Table 3.

Clinical Risk Scoring System for Long-Stay Hospitalizations In Medical Patients

Risk Factor	Pointsa
Age <80	2
Male	1
≥4 chronic diseases	4
Primary payer
Medicare	0
Medicaid	3
Private	2
Self-Pay	2
Other/no charge/missing	2
Primary diagnosisb:
Sepsis	2
Congestive heart failure	1
Pneumonia	1
Stroke	2
Respiratory failure	2
Comorbiditiesc:
Acquired immune deficiency syndrome	2
Alcohol abuse	1
Deficiency anemia	2
Rheumatoid arthritis/collagen vascular diseases	1
Chronic blood loss anemia	2
Congestive heart failure	2
Chronic pulmonary disease	1
Coagulopathy	3
Depression	1
Diabetes (with or without complications)	1
Drug abuse	1
Hypertension	1
Hypothyroidism	1
Lymphoma	2
Fluid and electrolyte disorders	4
Metastatic cancer	1
Other neurological disorders	1
Obesity	1
Paralysis	3
Peripheral vascular disorders	1
Psychoses	2
Pulmonary circulation disorders	2
Renal failure
Solid tumor without metastasis	1
Valvular disease	1
Weight loss	6
Hospitalization characteristics
Winter season (December, January, February)	1
Weekday admission (Monday to Friday)	1
Not admitted through the Emergency Department	2
Admitted as a transfer from another healthcare facility	3

^aAn individual patient’s Clinical Risk Score is derived by summing the points for each risk factor present on admission

^bDefined by primary ICD-9-CM discharge diagnosis groupings, based on the Agency for Healthcare Research and Quality’s (AHRQ) Clinical Classifications Software.

^cDefined by the HCUP comorbidity software, which identifies coexisting medical conditions that are not directly related to the principal diagnosis, or the main reason for admission, and are likely to have originated prior to the hospital stay. Comorbidities are identified using ICD-9-CM diagnoses and the Diagnosis Related Group (DRG) in effect on the discharge date.